Melanie knows she needs to do something about her health. She has gained ten pounds, can’t sleep at night because she is sweating like crazy, and cries at the drop of a hat. Her husband barely speaks to her.
Melanie doesn’t want to mention her issues to her friends. She tries to find information about hormone-related changes online but finds it all too overwhelming to weed through.
Even if she decided to try “hormone replacement therapy,” there are so many choices! Creams, gels, pills, and pellets?? And words alongside these suggestions like “unsafe” and “dangerous” scare her to death!
Melanie feels so alone and misunderstood…. she just wants to feel normal again.
The above scenario may be a familiar one to perimenopausal or menopausal women trying to find answers to midlife changes. The internet can be a wealth of knowledge or your worst enemy, depending on where you look. For those of you starting on your journey into “hormone harmony,” refer here for more information regarding the truths about hormone replacement therapy.
A common issue women encounter after deciding to pursue hormone replacement therapy is which route of administration to choose. One option, implanted hormone pellet therapy, offers a unique way to deliver hormones into your body.
What Are Hormone Pellets? How Do They Work?
Hormone pellets are about the size and shape of a grain of rice. The pellets are implanted under your skin, usually in your hip or lower abdominal wall, where they settle and slowly dissolve over a 3-4-month period. The pellets do not have to be removed.
How many pellets you need depends on your symptoms and hormone levels. This is a discussion that your health care provider will help guide you through.
The procedure is done in your health care provider’s office. The pellet is inserted subcutaneously, which means it is put in a fatty layer under your skin. After the procedure, patients are instructed to avoid strenuous activity or water exposure for several days after implantation. This is to ensure that the pellet doesn’t shift or come out of the skin.
Hormones that can be delivered via pellet therapy include estrogen and testosterone.
What Are the Benefits Compared to Other Hormone Therapy Options?
- Easier to Use: Many women enjoy the freedom they receive from not needing to remember to take their medication daily.
- Improved Adherence: Some of the methods used to alleviate hormonal symptoms only work if taken exactly as directed. Meaning if you apply them incorrectly or forget to take them, they won’t work.
- Method of Delivery: The pellets are designed to administer hormones similarly to how they would be released in your body. In other words, there might not be as many noticeable “highs” and “lows” as you would experience with different routes of administration.
What Are Some Potential Pitfalls to Hormonal Pellets?
- Cost: Hormone replacement pellet therapy may be slightly more costly than other forms of treatment and insurance may not cover it
- Difficulty in dosing changes: While more pellets can be added after the initial procedure, pellets cannot be removed. I never recommend going with pellets as the first method of hormone delivery for women who are just getting started. It is too easy to get the dose wrong (especially if testosterone is in the mix) and then you’re stuck. This is why it is crucial to work with a healthcare provider with training and experience in hormone replacement therapy.
- Possible infection: since pellets are placed using a surgical incision, there are small risks of infection.
What are Side Effects of Pellets?
Side effects of testosterone pellets include facial hair growth, scalp hair loss, anger, irritability, clitoral enlargement, acne, and oily skin. All of these would indicate the dose is too high. Also, some women aromatize their testosterone to estrogen. This results in signs of estrogen dominance such as breast tenderness, heavy periods, weight gain, and a possible resumption of bleeding in menopausal women.
Side effects of estrogen pellets can include breast tenderness, bloating, headaches, heavy periods, weight gain, and a possible resumption of bleeding in menopausal women.
How Often Do They Need to Be Reinserted?
Hormone dosing depends on each individual’s symptoms and levels, but it is generally 3 to 4 treatments per year.
The Bottom Line
Pellets offer a convenient way to receive BHRT. Hormone replacement therapy, regardless of the route of administration, is an option for perimenopausal and menopausal women to help improve their quality of life. Dosing and administration of therapy should only be done by a healthcare provider who has hormonal replacement therapy training and experience.
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Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at www.perimenopausebook.com.
Dr. Anna is available for 1-1 consultations. Find out more at www.drannagarrett.com/lets-